Provider Demographics
NPI:1558515460
Name:PRINCE-GRIFFIN, PATRICIA ELIZABETH (MS)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ELIZABETH
Last Name:PRINCE-GRIFFIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 S HIGHLAND ST
Mailing Address - Street 2:APT 201
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-4567
Mailing Address - Country:US
Mailing Address - Phone:901-438-8141
Mailing Address - Fax:
Practice Address - Street 1:232 S HIGHLAND ST
Practice Address - Street 2:APT 201
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-4567
Practice Address - Country:US
Practice Address - Phone:901-438-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered